Inserting an IUD or IUS (Mirena)

If you decide use an IUD or IUS for contraception, you will need to make an appointment to get it inserted.

If your GP does not insert IUDs, they will refer you to another GP who does. They will write a letter to the GP, including information about any relevant previous tests you've had. This will include the results of your recent cervical smear tests.

The GP you are referred to may want you to have an extra appointment before your IUD is put in.

To make sure you are not pregnant on the date planned to fit your IUD, you must either:

be using reliable birth control, or

not have sex from the first day of your period until after your IUD is fitted.

Who should not have an IUD or IUS?

Please tell your GP if you:

have a blood disorder

are on blood-thinning medication

have pelvic pain or discharge

have a heart murmur or rheumatic heart disease

are unwell with a fever on the day you plan to have the IUD inserted

have been pregnant within the past four weeks.

Arranging the appointment

You will need to organise the appointment. You will probably be asked to ring the GP – check with your usual general practice whether they have made an appointment for you, or if you need to do this yourself.

What happens when the IUD is inserted?

Before the appointment

It's a good idea to take some pain relief one to two hours before your appointment. Paracetamol or an anti-inflammatory such as ibuprofen is suitable.

You should arrange to have someone you can call to come and collect you in case you feel too unwell to drive, although this is very unlikely. You might like to arrange a support person to come with you.

What happens during the appointment?

First, the doctor will want to check the size and position of your womb. They will do this by gently placing two fingers in your vagina, then placing the other hand on the lower part of your abdomen.

The doctor will then insert an instrument called a speculum into your vagina (like when you have a smear test).

They will then place a holder on your cervix to keep it steady while they move a thin instrument through your cervix into your womb. This measures the length of your uterus and opens up the cervix so the IUD can be inserted.

The doctor will then insert the IUD.

You may feel some cramping while this is happening.

After the appointment

You may have some spot bleeding for a few days – please bring a pad with you.

A few women feel light-headed and nauseous after they have an IUD inserted. If this happens, it normally only lasts a short time. This is why it's important to organise someone who can collect you if you don't feel well enough to drive.

There is a very small risk of pelvic infection from the procedure. You may feel some pelvic discomfort for a short time after the procedure, but if you have any pelvic pain, or abnormal discharge more than 48 hours afterwards see your doctor.

You should not have sex or use tampons for the first 48 hours after the IUD is inserted, as this may increase the risk of infection.

When will I be safe from pregnancy?

Copper IUDs protect you against pregnancy as soon as they are fitted.

A Mirena IUS doesn't work as a contraceptive until seven days after it is put in (unless it was fitted within seven days of the start of your period).

Follow-up

You may have a follow-up visit six weeks after the procedure with your GP or the GP who performed the procedure. This is to check the strings from the IUD or IUS, and discuss any concerns you might have about the device.

If you have any problems before this appointment, please contact your GP or the after-hours service.